Emerson Hospital is one of just a handful of independent community hospitals left in Eastern Massachusetts, and for now it plans to stay that way, according to CEO Chris Schuster. But a look at the hospital's financials show the challenges community hospitals face, including downward pressure on reimbursements for government health programs, and an increase in free care. "We are also seeing increased competition from doctors' groups, a nearby standalone endoscopy center, and urgent care centers, including Minute Clinics," Schuster said. "As a hospital, we have to be here 24 hours a day, and it's tough when others cherry-pick high-margin business during the daytime hours."